SearchFlorida374J00000X

Tierra Russell, CPPD

NPI 1396478061 · on the registry since 2022 · sole proprietor

Practice

Address
812 W Tiffany Dr Apt 3
Mangonia Park, FL 33407
Phone
(561) 335-0028

Registry record

Primary taxonomy
374J00000X
374J00000X
Licence states on file
FL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2022-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida